Healthcare Provider Details

I. General information

NPI: 1962518704
Provider Name (Legal Business Name): ORTHOTIC PROSTHETIC SOLUTIONS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1446 HOVER ST
LONGMONT CO
80501-2485
US

IV. Provider business mailing address

1446 HOVER ROAD
LONGMONT CO
80501
US

V. Phone/Fax

Practice location:
  • Phone: 720-652-0100
  • Fax: 720-652-0202
Mailing address:
  • Phone: 720-652-0100
  • Fax: 720-652-0202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: BRENDAN JASON RILEY
Title or Position: OWNER
Credential:
Phone: 970-484-8388